Bladder Volume Wall Index in Children with Urinary Tract Infections

Few studies have focused on the correlation between bladder ultrasound and urinary tract infection. The aim of this study was to evaluate the bladder volume wall index in children with single or recurrent urinary tract infection. This case-control study was conducted between March 2008 and December 2009. The study was performed on one hundred children [8 boys, 92 girls] aged 4-15 years with a history of urinary tract infection and thirty-nine [20 males, 19 females] age- matched healthy children who had negative urine culture one month before investigation. The kidneys, ureters, and bladder sonography were performed in all children. Bladder volume wall index was calculated for each child and the result of 70-130 was presumed normal. Student T-test, chi-square, likelihood ratio, and risk ratio were used. P-value <0.05 was considered significant. The mean bladder volume was 262.5 [ +/- 82] in recurrent urinary tract infection, 235 [ +/- 54] in single urinary tract infection, and 278 [ +/- 80] in controls [P<0.05]. The bladder was thick [<70] in 37 [28 cases, 9 controls] and thin [>130] in 38 children [28 cases, 10 controls] [P>0.05]. The median residual volume was not different between the two groups. The abnormal BVWI in children with vesicoureteral [VU] reflux was 75% as compared to 51% in those without VU reflux [P>0.05]. There was no correlation between BVWI and age, gender, groups, vesicoureteral reflux status, or residual volume [P>0.05]. According to our findings, the bladder volume wall index is not sensitive enough to discriminate children who are prone to urinary tract infection

Correlation between Lower Urinary Tract Scoring System, Behavior Check List, and Bladder Sonography in Children with Lower Urinary Tract Symptoms

PURPOSE: The Pediatric Lower Urinary Tract Scoring System (PLUTSS) is a standardized questionnaire used for screening and evaluation of the response of children with lower urinary tract symptoms (LUTS) to therapy. We presumed that adding the Child Behavior Check List (CBCL) and bladder volume wall index (BVWI) to the PLUTSS would increase its validity in the detection of children with LUTS. MATERIALS AND METHODS: One hundred twenty-two children aged 5 to 15 years with LUTS were enrolled in the study. Seventy-two healthy, age-matched children without urinary complaints were considered as controls. The PLUTSS and CBCL were filled out for all children. Sonography was performed to measure BVWI. Chi-square test and likelihood ratio were used to compare frequencies, receiver operating curve (ROC) analysis was used to evaluate the correlation, and Cohen's kappa was used to measure the agreement between variables. p-values 0.05). ROC analysis showed that there was no correlation between PLUTSS, CBCL, and BVWI in either the LUTS subgroup or in the controls (p>0.05). The PLUTSS had the highest sensitivity and specificity, and adding the two other tests decreased its validity for the diagnosis of children with LUTS. CONCLUSIONS: The PLUTSS by itself was the best predictor of LUTS. The CBCL and BVWI were not helpful in making a diagnosis; however, the CBCL was useful in the detection of behavior problems in children with non-monosymptomatic enuresis.

Huge obstructive bladder diverticula and cystic dysplastic kidneys in a newborn: a challenging dilemma

This study investigated a 63-day boy with end stage renal disease and abdominal cysts. The antenatal sonography detected anhydraminos, posterior urethral valve, and cystic dysplastic kidneys. Voiding cystourethrogram revealed two obstructive giant diverticula which at first looked like enlarged renal pelvis. The patient had persistent urinary tract infection and perforation of diverticula. The dialysis was ineffective because of leakage, immeasurable inflow and dwell volume, peritonitis and tunnel infection. As a result, the availability of automated peritoneal dialysis for infants is recommended to reduce morbidity and increasing the survival rate. Nonetheless the giant bladder diverticules might be better managed by diverticulectomy procedure